MEDICARE: DR. MARY HELEN MCCARTHY D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	5101014825	MI

General Provider Information

NPI Number	:	1639158132
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY HELEN MCCARTHY D.O.

Provider Business Mailing Address
First Line	:	3801 FAIRFAX DR STE 44
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22203-1762
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3801 FAIRFAX DR STE 44
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22203-1762
Country	:	US
Telephone Number	:	703-522-4780
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2006
Last Update Date	:	01/23/2013

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